Background: Cardiopulmonary resuscitation (CPR) is part of the standard of care for the event of cardiac arrest during hospital admissions. The “do not resuscitate” (DNR) order documents that patients do not wish to pursue CPR in the event of cardiopulmonary arrest (CPA). The Ministry of Health has announced that 69.7% of middle-aged home residents in [...]

Background:   Hyperkalemia (HK; serum K+ ≥5.0mEq/L) is a common electrolyte imbalance, associated with an increase in all-cause mortality and hospitalization.  Moderate to severe HK (K + levels ≥5.5mEq/L) is often managed in the emergency department or hospital, where available treatment options include methods to temporarily lower K+ (e.g., insulin-glucose and beta 2 agonists), use [...]

Background: Venous thromboembolism (VTE) is a well-known complication in patients who are hospitalized. It is a recommendation of the Joint Commission to prescribe prophylactic anticoagulation to prevent VTE, as prophylaxis is estimated to reduce the risk of VTE by 50-75%. Many hospitals are evaluated based on rates of acquired VTE, rather than if appropriate prophylaxis [...]

Background: Code status discussions often link do-not-intubate (DNI) orders with do-not-resuscitate (DNR) orders, although cardiac arrest accounts for less than 2% of endotracheal intubations. Furthermore, in-hospital cardiopulmonary resuscitation (CPR) is associated with worse outcomes than intubation. DNR orders are more commonly implemented for older patients with more comorbid conditions regardless of the reason for hospitalization, [...]

Background: Care of complex patients are a daily challenge in the hospital setting, with a direct impact on the health care costs. Although there is no standard definition of a “complex” patient, we can argue that they are patients who need more time and resources during their care process. Age and comorbidities are probably important [...]

Background: Co-management across service lines has become increasingly common in hospital medicine. SHM’s Co-Management Task Force has outlined several components of a successful co-management program. Recent studies have shown that cross-disciplinary service arrangements, which are more collaborative, enhance provider satisfaction and may improve patient care. These benefits have encouraged institutions to roll out multiple co-management [...]

Background: How to combat the corrosive effects of burnout during residency training remains a persistent question, but a supportive working environment has shown to be a protective factor.  Purpose: The Golden Ticket Project (GTP) is a novel wellness pilot program designed to encourage peer recognition within a pediatric residency program. Description: METHODS: Through an electronic [...]

Background: Acupuncture offers an inexpensive and safe method for symptom relief and is widely used in the outpatient setting. Given the increased focus on pain control, safety and cost awareness in the inpatient setting, acupuncture is a potential therapy to include in the care of hospitalized patients. We conducted a qualitative study to explore facilitators and barriers [...]

Background: Coronary artery calcification (CAC) is a strong predictor of cardiovascular events. We aimed to evaluate the prognostic significance of CAC detected by chest CT scan (CT) in heart failure (HF) with preserved ejection fraction (HFpEF) patients (pts) in the absence of coronary artery disease history (CAD Hx). Methods: In this retrospective cohort, we queried [...]

Background: The CHADS2 score is widely used risk stratification model for stroke in patients with atrial fibrillation (AF). The impact of height and other anthropometric measurements on the risk of stroke in patients with low CHADS2 score is yet to be identified. We aimed to evaluate the association between height and stroke in AF patients with [...]